Need help with C Peptide levels

[sugar spoon]

Hello folks,

I was recently diagnosed as a Type 1 Diabetic. It really sucked for the first few days, but with the help of my friends, family and from reading all the stuff here and on some other forums I'm feeling loads better now. So, thanks to everyone who is a part of this community. You guys are doing an amazing job!!

The thing is even though my doctor diagnosed me as a T1D, my C-peptide level is really confusing me, it's 1.29ng/ml. While I was researching about T1 after my diagnosis, I learnt that the normal level for C-peptide is b/w 0.5 - 2.0 ng/dL. So, yes I would love to hear your thoughts about it.

Also my doctor put me on NovoMix 30, (20U morning, 10U night) and it works really well (never faced a hyper, but a hypo once). Here are some more numbers that might help -

• 
  
• Fasting BG on day of diagnosis - 249 mg/dL
• Age - 24
• Lost about 12 Kilograms in 4 months prior to diagnosis
• HbA1c - 14.1%

I have asked for a meeting with my doctor to discuss this, so every bit of knowledge that you share can help me ask the right questions.

Thank you!!

 

[EllieM]

Has he done an antibody GAD test? If so and it's positive, then the c-peptide just means you still have some insulin production, ie you are in your honeymoon period.

Reasons to make T1 more likely
1) weight loss (that's a major symptom)
2) relatively young
3) fast progression of illness?

Reasons to make T2 more likely
1) family history of T2
2) overweight at diagnosis
3) high c-peptide result (T2s generally overproduce insulin in a vain attempt to process carbs).

My guess is that if you are truly T1 then future c-peptide tests will go down. And honestly, with those symptoms, it would probably take a very high c-peptide level for the doctor to diagnose you as T2.

But in any case congrats on the good blood sugar management.

 

[sugar spoon]

Hey @EllieM , happy to see a quick reply. Thank you so much!!

Has he done an antibody GAD test?

No, there's nothing called a GAD test on my reports.
Will make sure I ask my doctor about it.

Reasons to make T2 more likely
1) family history of T2
2) overweight at diagnosis
3) high c-peptide result

Nope, none of these factors are present in my case. So looks like the doctor is right.

But in any case congrats on the good blood sugar management

Thank you, even I didn't expect it, given that I'm a newbie. It has hugely boosted my morale.


Cheers!!

 

[ert]

Welcome. A fasting c-peptide of 0.2265 ng/ml or less on diagnosis would confirm type 1.
As this is not you, it leaves you with some other options: A positive GAD, IA2 or ICA antibody tests would also support type 1. You could ask for a MODY test with your normal c-peptide, age, weight loss, and diabetic blood sugars. Otherwise, it's a waiting game, to see if your c-peptide decreases to below 0.2265 over the next 5 years.

 

[sugar spoon]

Hello @ert,

You could ask for a MODY test with your normal c-peptide, age, weight loss, and diabetic blood sugars.

So T1 and MODY share similar symptoms? Is there any other noticeable symptom which can differentiate the two.

Otherwise, it's a waiting game, to see if your c-peptide decreases to below 0.2265 over the next 5 years.

Wow! I didn't know that the honeymoon phase could last for 5 years.
I was thinking it just takes a few weeks to months. Now I know.


Thank you so much for the reply!!

 

[ert]

Hello @ert,


So T1 and MODY share similar symptoms? Is there any other noticeable symptom which can differentiate the two.


Wow! I didn't know that the honeymoon phase could last for 5 years.
I was thinking it just takes a few weeks to months. Now I know.


Thank you so much for the reply!!

MODY has type 1 symptoms but a normal c-peptide. A lot of type 1's get a short honeymoon. A group of type 1's (often referred to as LADA) have a slow progression.

 

[EllieM]

So T1 and MODY share similar symptoms? Is there any other noticeable symptom which can differentiate the two.

MODY is a genetic illness, and sufferers usually have other family members with diabetes (not necessarily MODY). Otherwise, it's much rarer than T1 (maybe 10% of all diabetics are T1, while only 1% are MODY?). Just as T1s often get initially misdiagnosed as T2 (and much more rarely the other way round) MODYs often get an initial misdiagnosis of T1. So while you are probably T1, there is still a very small chance that you are T2 or MODY, but time will tell. The most important thing is that insulin injections are keeping your levels normal and thus protecting you from physical damage.

 

[sugar spoon]

Thank you @ert, I didn't know that. Everyday I learn something new about this condition.

Thanks @EllieM, for that detailed explanation. Anyway, my doctor assures me it's type 1. But I insisted him to give GAD test a try. Waiting for results now, fingers crossed.

 

[EllieM]

But I insisted him to give GAD test a try. Waiting for results now, fingers crossed.

A positive test will prove T1, but a negative test won't disprove it.....

 

[Toby789]

A positive test will prove T1, but a negative test won't disprove it.....

I am an even rare form of MODY (MIDD) and one of the endos at the genomics institute studying me is investigating T1s who do not have GADAs. All very interesting...!